Patient priority in A&E

[enigma]

Should an intoxicated patient be given priority in treatment in an A&E dept in hospital ? After having spent an exhausting four and a half hours in the A&E dept yesterday with my eight year old daughter - who as it turns out has a broken wrist following an accident at school yesterday - I was dismayed to see an intoxicated male who was being abusive towards other patients and becoming aggressive with staff , being given priority treatment - well ahead of my daughter who evidently was in a lot of pain , as indeed were many others. We had to wait to initially see the triage nurse , who in turn referred us to the x-ray dept (after a further hours wait) , then we had to wait to speak with a doctor who finally arranged for my daughter's arm to be set in plaster - following another lengthy wait. I fully appreciate that the doctors and nurses work gruelling shifts and toil endlessly , often without thanks for this service and so my argument does not lie with them per se , rather the patient priority. Why should an obnoxious , intoxicated patient , who seeks to antagonise hospital staff and patients be fast tracked to the treatment rooms ? I thought that priority was given - apart from those in dire need of medical assistance - to children and yet my daughter's wait was prolonged whilst this male jumped ahead of her to be treated for facial injuries. Whilst I accknowledge the importance of removing this man from the waiting room for the safety of the staff and patients , surely instead of rewarding his anti-social behaviour , he should have been issued with a stern warning and faced with an ultimatum ie cesssation of the hostile behaviour or treatment would be postponed until he could act in a civillised manner. What is the longest fellow ABers have had to wait in A&E and is this the norm ?

[orphi]

Hi all, and to enigma I am sorry for the experience you had with your child. This is not an uncommon occurance unfortunately, it is a symptom of our society today and the more unpleasant side of human behaviour. The most important issue here speaking as a Nurse, is the fact that all nurses are bound by local policy and the NMC guidlines. We are bound to adhere to these rules, by the laws which are part of our registration guidlines. So, in short, even if as a Nurse we abhor a patients behaviour, we have to act in accordance to the local policy or NMC (Nursing and Midwifery Coucils' )guidlines. If we do not, we can be prosocuted, sacked or loose our registration. So its a q for the boys in the board rooms and government!

It's a difficult one to answer, any one of us could end up in that situation, without sounding like I am condoning this type of anti-social behaviour, we are all capable of becoming unstable (speaking as a Mental Health Nurse), we could all hit rock bottom. Who knows whats around the corner, all it takes is a bump to the head or the devastating loss of a loved one, and we could act as offensively as that guy. Im sure theres someone here reading this post whos got absolutely rat ar** or done something out of character, after severe emotional trauma.

Imagine postponing treatment becuase someone is hostile, well if that where the case, I am sure that thousands of mental health patients (mums, dads, bro's, sister etc, would be DEAD.....imagine that. I have been smacked, bit,punched by people who are sick.....a month later, they are hugging you. I hope most of all your daughter has not been traumatised by her injury and she is feeling better, I also wish you the very best and your family. Orphi.

[enigma]

Part 1 : Joko - I really can not understand why you seem hell bent on turning this into some kind of personal vendetta. I have no fight with you and am most indifferent to your petty insults. You keep saying 'peace' and yet there is very little evidence in your posts to reinforce this. I was gracious enough to offer up the white flag in the form of an apology in an attempt to draw closure to this futile bickering which you seem intent on continuing and yet you still can't seem to shake off the bit between your teeth. Let go and actually mean what you say - peace.

[enigma]

Part 2 : Having read all the answers again at great length , I noted that what I had forgotten about was that it was in fact you who attacked me in your second post. You accused me of putting words into your mouth and told me not to tell you what you had said. I was summarising what I thought was the gist of your post (reading between the lines) and am still baffled as to why you felt the need to exclaim , through the use of punctuation , that the man was not there just because he was drunk. When did I say otherwise ? I am also acutely aware of how serious an ectopic pregnancy is and didn't need it spelled out to me - with you reiterating the fact several times over your posts that a broken wrist is non life threatening. Again , I am well aware of this fact. You have grossly misquoted me on several occasions ie stating that I did my 'panic stricken mother act' (which didn't happen - I don't know where you pulled that one from). A clear example of YOU putting words ino MY mouth.You also ask why I feel that my daughter should have been given special treatment when I have stated on numerous occasions that there were far more serious cases than my daughter and that I DIDN'T think that she should have been treated first. You state that I am not medically qualified to answer questions pertaining to this man's condition - by my own admission I stated that I am not medically qualified.

[enigma]

Part 3 : You seem to be picking up on anger and feelings of hostility in my answers where there are none. Is this because you harbour such negativity and ire yourself and without the ability to feed from barbed comments you fail to thrive ? I continuosly post answers which quite clearly state that I bear no ill feeling towards you , have no anger in the tone and content of my posts and I am perfectly composed , yet you in turn habitually post comments about my supposed rage and dischord. Why ? To clarify - please do take time to read this - my comments are borne out of frustration - not anger. I am a mother who loves her children dearly and who would do anything to protect them. I would be failing in my duty as a mother if I did not seek to protect my children from harm nor took a keen interest in their welfare. Why is this so hard for you to understand ? I welcome your difference of opinion but when you make ridiculous statements like ' stop getting irate with people and looking for personal slights where there are none' then I feel the need to address this issue and defend myself and ask where you acquire your source from. I always try to be as helpful as I possibly can and most often than not , sign off with 'hope this helps x ' In what way is this getting irate ? If putting an x at the end of my answer is an example of me getting cross , then I stand guilty as charged !

[enigma]

Part 4 :

'I don't get angry with people unless they start it and they will be left in no doubt whatsoever of my meaning' - That really says it all. With all due respect , The hypocrisy speaks for itself. May I ask , is this the point where you refer to people as 'braindead idiots' ? I have differed in opinion many a time on AB but have never felt the need to resort to personally insulting fellow ABers. You lose your whole argument when you do that and devalue your opinion. You can dress it up whatever way you like but there is no justification in speaking to others in that way. By your own admission , you say that you sometimes get angry on here and yet you pick me up on my supposed anger (?) I may get frustrated or feel a little insulted sometimes but I do not get myself worked up into a rage and most certainly do not feel the need to insult anyone who does not agree with me. Perhaps it is you who should look at dealing with your anger issues and finding better ways of controlling your pent up rage , if you get so worked up by comments on a web site. Perhaps then I won't be so accustomed to identifying your name with several snippy posts. If you read the answers again you will indeed - or should undoubtedly - see that it was you who jumped down my throat telling me not to tell you what you said. Peace ? I do hope so.

[enigma]

Orphi - Thank you for your kind comments. My daughter has bounced back as I had imagined she would. Children are very resillient and sometimes are not given enough credit for their coping mechanisms. No parent wants their child to feel distressed and I am no different from any other. I was just unfamiliar with the whole A&E process as I have been pretty fortunate up until now - touch wood ! I appreciate your input - especially given the nature of your profession. I take on board your comments re mental health issues. There may indeed have been underlying issues with the male in question although this can not possibly account for the alarming number of intoxicated patients who enact frightening displays of violence towards staff and patients. I wouldn't fancy your job for all the money in the world but I admire you for having the patience to do so. Keep up the good work x

[joko]

OH...MY...GOD!!!!!!!!
Your 20-odd posts, ranting about the same things over & over and not listening to anyone else, are becoming quite laughable. I've explained my point & so has everyone else. What I said in my first post was my opinion, if you want to read all kinds of nonsense into it (punctuation? jeez!) then that's your problem -youve already admitted thats what you did. My response was to you accusing me of some drivel & putting words in my mouth -you're clearly just using this site as an excuse for a good old moan.
How you can claim I jumped down your throat first & that I'm the one who's ranting is beyond me.
The evidence is there for all to see.
If this "tragedy" is all you have to whinge about then you're a very lucky person, but then I think you're the sort who would find something to moan about no matter what the situation (punctuation?) -you're clearly unable to understand properly or judge situations. Re-read your posts & you'll see where the panic stricken mother comment comes from-that is how you come across.
Grow up & get a life.
By the way, I said they were starting to sound like braindead idiots -because much more of the disgusting idiotic hatemongering they were spouting & thats exactly what I'd think of them, that's how they were coming across -it was, in my eyes, a fact, not just said purely as an insult. Some of what they were saying was starting to sound like it was coming from a mindless thug lynch mob. I didn't just say it out of the blue for no reason.
Seems people can be as offensive as they like, as long as they say it with nice english prose, but use some simple words that amount to the same thing & people get upset. mmm...
I await your 5 rambling posts in reply (just copy & paste the others, they'll say the same thing & save you time & I'm not interested anyway)